Cost-effectiveness of a stepwise intervention to promote adherence to cervical cancer screening

被引:2
|
作者
Firmino-Machado, Joao [1 ,2 ]
Soeteman, Djora, I [3 ]
Lunet, Nuno [1 ,4 ]
机构
[1] Univ Porto, EPIUnit Inst Saude Publ, Porto, Portugal
[2] ACeS Porto Ocident, Unidade Saude Publ, Porto, Portugal
[3] Harvard TH Chan Sch Publ Hlth, Ctr Hlth Decis Sci, Boston, MA USA
[4] Univ Porto, Dept Ciencias Saude Publ & Forenses & Educ Med, Fac Med, Porto, Portugal
来源
EUROPEAN JOURNAL OF PUBLIC HEALTH | 2020年 / 30卷 / 03期
关键词
WOMEN; BREAST;
D O I
10.1093/eurpub/ckz222
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Cervical cancer screening is effective in reducing mortality, but adherence is generally low. We aimed to investigate the cost-effectiveness of a stepwise intervention to promote adherence to cervical cancer screening in Portugal. Methods: We developed a decision tree model to compare the cost-effectiveness of four competing interventions to increase adherence to cervical cancer screening: (i) a written letter (standard-of-care); (ii) automated short message service text messages (SMS)/phone calls/reminders; (iii) automated SMS/phone calls/ reminders + manual phone calls; (iv) automated SMS/phone calls/reminders + manual phone calls + face-toface interviews. The main outcome measure was cost per quality-adjusted life year (QALY) measured over a 5-year time horizon. Costs were calculated from the societal and provider perspectives. Results: From the societal perspective, the optimal strategy was automated SMS/phone calls/reminders, below a threshold of (sic)8171 per QALY; above this and below (sic)180 878 per QALY, the most cost-effective strategy was automated SMS/phone calls/ reminders + manual phone calls and above this value automated SMS/phone calls/reminders + manual phone calls + face-to-face interviews. From the provider perspective, the ranking of the three strategies in terms of cost-effectiveness was the same, for thresholds of (sic)2756 and (sic)175 463 per QALY, respectively. Conclusions: Assuming a willingness-to-pay threshold of one time the national gross domestic product ((sic)22 398/QALY), automated SMS/ phone calls/reminders + manual phone calls is a cost-effective strategy to promote adherence to cervical cancer screening, both from the societal and provider perspectives.
引用
收藏
页码:401 / 410
页数:11
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